[Histologic response of the myocardium to various immunosuppressor schedules in patients with dilated cardiomyopathy and diagnosis of myocarditis at endomyocardial biopsy].
OBJECTIVE
To analyse the histological evolution of endomyocardial biopsies from children with active myocarditis, submitted or not to immunosuppressive therapy.


METHODS
Four groups of patients were compared, clinically treated as follows: group I--anticongestive drugs (4 patients); group II--prednisone (5 patients); group III--prednisone plus azathioprine (9 patients); group IV--prednisone and cyclosporine (5 patients).


RESULTS
No patient from group I presented any histological improvement during a mean period of 9 months, while evident histological improvement occurred in 25% of patients from group I, 67% from group III and 80% from group IV. The microscopical aspect of resolving myocarditis was only observed in patients from groups III and IV, after treatment.


CONCLUSIONS
The immunosuppressive therapy with azathioprine or cyclosporine plus prednisone leads to decrease of active myocarditis intensity in a higher proportion of cases than the treatment with only prednisone or no immunosuppressive drugs.
Higuchi
M de L
Mde L
Instituto do Coração do Hospital das Clínicas, FMUSP.
Camargo
P R
PR
Aiello
V D
VD
Mazzieri
R
R
Snitcowsky
R
R
Fiorelli
A
A
Ebaid
M
M
Pileggi
F
F
D000293:Adolescent; D001379:Azathioprine / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003524:Cyclosporins / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D009205:Myocarditis / Q000188:drug therapy / Q000473:pathology*; D009206:Myocardium / Q000473:pathology*; D011241:Prednisone / Q000627:therapeutic use
D003524:Cyclosporins; D007166:Immunosuppressive Agents; D001379:Azathioprine; D011241:Prednisone
Resposta histológica do miocárdio a diferentes esquemas imunossupressores em pacientes com cardiomiopatia dilatada e diagnóstico de miocardite biópsia endomiocárdica.